HomeMy WebLinkAbout20154115.tiff NCMC BOARD OF TRUSTEES
Regular Session Meeting
Monday, July 27, 2015
Attachment 1
Minutes of Regular Session of
June 29, 2015 *
* - Action Required
NCMC Board of Trustees
Regular Session Minutes
Monday, June 29, 2015
12:00 Noon
The Board of Trustees of North Colorado Medical Center met in Regular Session on Monday,
June 29, 2015, in the Richard Stenner Boardroom located at North Colorado Medical Center.
Mr. Houtchens declared a quorum and called the meeting to order at 12:00 p.m.
ATTENDANCE REPORT
NCMC 'Board of Trustees: Catherine Davis, Brandon Houtchens, Mark Lawley, Michael
Simone, Jason Yeater, and Sean Conway (Commissioner, non-voting member) with
Dr. Susan Carter and Brian Underwood being excused
Banner Health: Rick Sutton (NCMC CEO) and Wendy Sparks (NCMC COO)
Staff: Ken Schultz (Board Executive)
Recording Clerk: Esther Gesick (Weld County Clerk to the Board)
PUBLIC COMMENT
There was no public comment,
APPROVAL OF MINUTES
It was MSC (Simone/Lawley) to approve the minutes from the May 18, 2015, Regular
Session meeting.
NEW BUSINESS
None.
CEO REPORT or COO REPORT
NCMC COO, Wendy Sparks, gave the following report:
• Employees - Employees were given $20 in Banner Bucks for use at the Independence
Stampede, which has been very positive. She noted that NCMC has a great presence
visible at the Stampede.
• Patient Satisfaction -There are eight (8) dimensions and Ms. Sparks explained that
NCMC has raised its Target so this is not Banner system targets; rather, they are just
looking at Rate. She said they are meeting Target on 3 of the 8 for NOCO hospitals and
working aggressively to meet the 80th percentile.
• Quality - Staff is also working on meeting Target for two initiatives: Care Reliability of
Total Joint Care and Care Reliability of Heart Failure Care; they are meeting target on
both Year-to-Date.
. Physicians -All physicians are being asked to participate in the Annual Physicians
Satisfaction Survey, which runs through mid-July.
Page 1 of 3 June 29,2015 NCMC Board of Trustees
• Financials - For the Greeley Community in May there was an operating loss of$480,000
due to a one-time prior year accounts receivable adjustment for BMG (specifically on
the anesthesia side), in the amount of$730,000. However, there is still an operating
gain of$7.5 million for the Greeley community Year-to-Date.
• Master Campus Plan - Staff moved into the new pharmacy space on June 8th and they
are very pleased with the larger area. In mid-July, the Oncology staff will be moving into
their new space and then begin Phase Three of the Cancer Center renovation. She
noted there will be a Community Open House around Labor Day. Lastly, the Third Floor
Summit View project is scheduled to open in mid-August, with 17 providers in the space.
VISITATION REPORTS
PHARMACY DEPARTMENT
Catherine Davis reviewed her report, dated June 24, 2015. A written copy of the visitation
report is attached as a part of these minutes. There was discussion regarding management
of the in-patient drug delivery system via the Pyxis machines and the resulting savings.
WOUND CLINIC
Jason Yeater reviewed his report, dated June 28, 2015. A written copy of the visitation
report is attached as a part of these minutes. There was discussion regarding the use of
hypobaric chambers (NCMC has not had them for quite some time) and a compression
measurement tool.
VISITATIONS FOR JULY
Dr. Susan Carter
Brandon Houtchens
NCMC, INC. REPORT
Ken Schultz reported it has been a quiet month with consistent quarterly results;
commenting he does not anticipate any major market changes before tomorrow.
COMMISSIONER'S REPORT
Commissioner Sean Conway reported the Commissioners have appointed Brian Underwood
to fill Dave Owen's vacant position and his first meeting will be in July due to a schedule
conflict today. He stated the recent Transportation Summit was very successful.
Additionally, the Commissioners will be rolling out the Bright Futures Weld County program
and making appointments to the committee after the July 4th holiday. The next objective is
to start marketing the initial $10 million that has been walled off for this program and
encourage the public to made tax deductible contributions to grow the amount up to $25
million. The first scholarships will be distributed in 2016. Lastly, he stated the work on
CR 49 is back on track following the recent spring flood event, and the roadway is still
scheduled to open by the end of September, 2015. Then they will proceed with the design-
build for the next phase and hope to be completely done in 2017.
Page 2 of 3 furze 29,2015 NCMC Board of Trustees
OTHER BUSINESS
None.
PLANNING SESSION
No discussion was held on scheduling a future planning session.
ADJOURN
There being no further business to come before the Board, it was MSC [Simone/Davis] to
adjourn the meeting at 12:43 p.m.
Respectfully submitted,
Esther Gesick
Page 3 of 3 June 29,2015 NCMC Board of Trustees
NCMC Pharmacy Department Review June 24, 2015
Catherine C. Davis, Ph.D.
Summary: Recently,the Pharmacy Department underwent a major renovation
moving to an outstanding, 10,000 ft2 new facility that houses 22 FT pharmacists and
18 FT pharmacy technicians. The move occurred without interruption of patient
services. The space contains a state of the art clean room, refrigeration for treatment
biological, and enhanced security of prescription narcotics.They have state of the
art management of in-patient drug delivery via the Pyxis system (soon to be
upgraded to Pyxis ES) that addresses safety and reliability. Physician-directed and
pharmacist-managed. Beyond in-patient capabilities,they support rural hospitals
and have outreach clinics for ambulatory care patients such as coagulation clinics
Background
Management Team: Richard Eihelling*, Pharm.D., R.Ph, Director
Keily Willoughby, R.Ph, Pharmacy Senior Manager
Connie Werbelow, Senior Operations Director
Will Goode*, Pharmacy Technicians.
Joseph Mulroy*, Pharm.D., PGY1 Resident
*Met with these personnel
History of Contacts:
Richard Eihelling graduated from KU--School of Pharmacy and then completed a
residency at The University of Iowa Hospitals and Clinics. He has almost 17 years
tenure with NCMC. William Goode graduated from UNC and completed his
Pharmacy Technician training in the Navy and has almost 20 years of NCMC tenure.
Joseph Mulroy received his Pharm.D. from the University of New Mexico. is at the
end of his one year residency and will be joining a Texas Pharmaceutical Firm.
Revenue/Budget: 17 million in-patient with
—13.3 million drug supplies
—3.7 million in salaries
Security: With the storage and distribution of prescription narcotics in the
pharmacy, safety of staff and security of medication is important. Physical barriers
to the medications are controlled by a variety of means.
1. Window and phone communication with pharmacy from hallway
2. Horseshoe configuration around pharmacy department with monitored security
cameras
3. Safes for medication that require employee id,biological id,and doing inventory
of remaining drug in safe after prescriptions are removed. If discrepancies are
noted, follow-up (Deter, Detect, Follow-Up)
Safety: Meets USP 7922 for sterile preparation of injectables,intravenous
medications, (including toxic compounds for chemotherapy). Consists of anteroom
for preparation to enter clean room,bounded by green tape,
1
gowns/footcovers/sterile gloves,masks, protective eyewear required in cleanroom.
Negative pressure maintained in preparation room to vent fumes outside. In former
facility, consisted of a glove box where pharmacist would stand in front of a cabinet
-met requirements but not functional for high capacity.
Pyxis system upgrade coming. Retained old 4,000 square feet to upgrade system.
Password and Bio ID protected and secured on floor for dispensing by nursing staff.
Unique:
Rural medicine management: Centers for Medicare and Medicaid Services (CMS) and
accreditation organizations have regulations and standards requiring hospitals to
provide a consistent continuity of care, 24x7. The goal of these standards is to
ensure a pharmacist, prior to administering the medication to a patient,
prospectively reviews all non-emergent patient medication orders. Not all rural
Banner hospitals are staffed 24 hours by an RPh. Thus,all pharmacists in the NCMC
clinic are also licensed in Nebraska,Wyoming, Nevada as well as Colorado to help
manage critical access. For enhanced patient safety, NCMC serves as a provider site
for remote pharmacy services (—telemedicine) so that all prescriptions dispensed
can be reconciled without a delay. They are the industry standard for this.
PGY1 residency just started. J. Mulroy will complete residency the end of this month.
New resident is a graduate of Drake University(DesMoines, [A). Residencies are
now key for graduates to work/direct hospital pharmacies
Pharmacy assistance: Ambulatory care clinics to support indigent.Also have
coagulation clinics.
Challenges/Obstacles:We can't increase what Medicare pays us so we need to
ensure that we have a sustainable business model.
Departmental Needs/Requests; Thank them for supporting the recent facility
expansion and enhancement.To increase patient safety and enhance physician care,
recommend a 24-hour staffing of pharmacist in Emergency Room to review
medications, monitor the potential for drug-drug interactions,and assist with any
pharmacy relevant information
Suggestions for improvement: Standardize how we deliver pharmacy services
throughout Banner—perhaps too Arizona-centric as management is located in
Phoenix.
What Wojild The Department Manager/Director Like NCMC Trustees To
Know: "I am proud to work here. This facility, Banner Health and NCMC, has
treated me very well. This is a high-performing pharmacy.They have an
outstanding business model where they are focused on the best interest of the
patients, employees,and business. Need to look out for all three,while having a
sustainable business model-otherwise,we will suffer"
2
NCMC Board of Trustees Report
Jason Yeater 6/28/15
Wound Clinic
Name of Contact: Karen Zack
History of Contact: Karen is a registered nurse and has been a part of Banner for 18 years. Karen was
named the interim department head of the wound clinic in February and retained the position officially
in April.
Department History and Services:The Wound Clinic primarily functions as an outpatient service. It has a
total of seven rooms and sees an average of 28-32 patients per day. Most of the patients are outpatient
wounds and are seen anywhere from 15 minutes to an hour then discharged.The staff in the wound
clinic typically consists of two CNA's and 2 RN's. Recently they lost an RN and have been working to
replace the position. In the interim the clinic has utilized a floating RN from Banner Staffing. On
Thursdays the clinic transitions its focus to that of a burn center. During this time a physical therapist
and occupational therapist are on the floor to help out with the specialized therapy required for burn
patients.
Successes: The wound clinic has been very successful in reaching their patient satisfaction target.They
have been able to accomplish this by having a staff focused on providing great care within a friendly and
caring environment. Within my time in the wound clinic all of the staff seemed dedicated, happy, and
pleased with their job. Morale is no doubt one of the driving factors that have allowed the department
to reach their patient satisfaction goals.
Future:The wound clinic has a goal to become nationally accredited. By achieving this,they feel they
would raise the level of training while allowing the wound clinic to be more recognizable and credible
within the community.
The wound clinic is not solely focused on clinical outcomes; it has a goal of becoming profitable within
the very near future.They are looking at staffing and workflow to do this.The wound clinic does
recognize that their space is not big enough, and has a plan to have the facility remodeled within the
next six months to increase the space from its current 7 room configuration to 10-11 rooms.
Challenges: One obstacle the clinic faces day to day is its lack of interaction between its wound software
(Wound Expert) and the hospital's software (Cerner). Currently when a patient is accepted into the clinic
the majority of data must be manually inputted into Wound Expert and once discharged re-entered into
Cerner.This has implications when a patient is under the wound clinic's care and has a visit with another
hospital department. Issues of medication reconciliation, wound treatments, etc. could be an issue.
Wants:The clinic feels like they get great support from the administration.The clinic would like to have
nitrous oxide and hypobaric oxygen piped into all the rooms.This would allow them to keep more
patients treatments in the clinic and not have to outsource.The Wound Clinic would also like to get a
compression measurement tool to assess staff treatment and care of open wounds.
Hello